Putting pupils’ health first on the agenda

Obesity is one of the major health issues facing our society, and its impact on children is especially troubling. Recent statistics show that in the UK, 25 per cent of boys and 33 per cent of girls between two and 19 years of age are overweight or obese. Obesity costs the economy £2 billion every year. It can lead to a number of serious health problems like type two diabetes (which is growing at a worrying rate), and even shorten lives by as much as nine years. It is imperative that we do our utmost to guarantee a long and healthy life for our children.
    
Facing the issue head on
Part of the challenge lies in recognising the problem. The Peninsula Medical School in Plymouth has found that parents are poor judges of their own children’s weight issues, with three quarters failing to recognise that their child is overweight. In fact, one in ten of the parents surveyed expressed concern about a healthy-weight child being underweight.
    
The causes of childhood obesity are self explanatory – children are failing to exercise in sufficient amounts, and their diets contain too much junk food. Many experts are looking to school meals as a key line of defence, as it allows school caterers to ensure that children get the right nutrients.

Activity guidelines
The World Health Organisation (WHO) said in its pamphlet ‘Global Recommendations on Physical Activity for Health’ that “physical inactivity is now identified as the fourth leading risk factor for global mortality.” The organisation advises that while exercise regimes should be undertaken with care, “across all the age groups, the benefits of being physically active outweigh the harms.” WHO recommends 150 minutes of physical activity a week, a measure that most British children currently fall short of meeting.
    
It is advised that “children and youth aged 5–17 should accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity daily”, and that “amounts of physical activity greater than 60 minutes provide additional health benefits.” The pamphlet also says: “Most of the daily physical activity should be aerobic.”

A psychological perspective
The British Psychological Society has carried out research into the psychological implications of obesity. Looking at the population as a whole, they have found that people frequently overestimate how active they are; while only six per cent of men and four per cent of women meet the government’s recommendations for weekly exercise, self reports were much higher. A 2011 BPS report said: “In short, despite well‑known benefits, only a minority of people in industrialised countries are sufficiently physically active to have a beneficial effect on their health.”
    
Acknowledging that “sustaining changes in physical activity levels remains a challenge,” the BPS advise that obesity should be tackled at the community level. “Anecdotal evidence from a cross section of healthcare teams in England and Wales (27 out of 57 contacted) suggests that although there are obesity clinics working specifically within local healthcare teams, some clinicians are not confident in knowing how to implement behaviour change and motivation strategies.” While the BPS study is not directed specifically a school age children, its warnings must be heeded by school leaders and all others responsible for children’s wellbeing.

The stress link
Other health bodies are working to identify the link between weight and mindset. Recent research from the Endocrine Society has indicated that stress can contribute to childhood obesity. It was found that overweight children as young as eight had higher than average levels of the stress hormone. While the findings give cause for concern, a causal link cannot yet be conclusively drawn – Dr Erica van den Akker commented that “we do not know whether obese children actually experience more psychological stress or if their bodies handle stress hormones differently.”

Signs of improvement
There has recently been encouraging news on the childhood obesity front. The National Child Measurement Programme’s 2013 survey revealed that for the first time in six years the number of overweight children had fallen. While the decrease was modest (33.3 per cent of pupils overweight or obese in 2012-13, down from 33.9 per cent the previous year), it is nonetheless a sign that current campaigns are making progress. Kingsley Manning, chair of the Health and Social Care Information Centre, said: “The first drop in obesity prevalence among year six stands out, although we will need to see what the numbers say in future years to determine if this is the start of a decline or more of a blip.”

School initiatives
Northamptonshire County Council have recently stepped up the fight to tackle obesity in children and young adults. Almost a tenth of Northamptonshire children are obese starting school, while a quarter are overweight. By Year Six, this goes up to one in six children – a worrying statistic.
    
The council’s public health service held an event in January which looked at innovative ways to reduce these numbers. Cllr Robin Brown, said: “It’s vital that we look at new ways to reduce childhood and young adult obesity and improve the health of the county‘s children. We know that children and young people enjoy using the latest technology and so it makes sense that we look at how we can harness its potential to motivate behavioural change such as increased physical activity and healthier eating.”
    
Eastfield Primary School in Enfield, London has also undertaken to reduce obesity in school age children. The school is taking part in the ‘Change4Life’ campaign, and will be running cookery classes for children as well as encouraging ‘Smart Swaps’ like having fruit instead of crisps. Headteacher, Christalla Jamil said: “This is a really big issue and we want to educate parents and children to make simple changes to their packed lunches such as eating nutritious food instead of crisps. It is all about moderation, of course, we can’t expect everyone to stop eating unhealthy food entirely.”The school will also put on after‑school activities to promote an active lifestyle for its pupils. The move coincided with Enfield being named one of the “fattest boroughs in London.”

Carrying progress forward
The measures taken by schools in recent times are encouraging. Public awareness is growing of the problem of childhood overweight, with nutrition campaigners like Jamie Oliver helping to put it on the agenda.

Furthermore, the aftermath of the 2012 Olympic games has seen investment going into fitness schemes to get children active and enjoy the benefits of aerobic exercise. However, it must be stressed that complacency is not an option. Long term predictions have typically forecast that by 2050 a half of British adults will be obese; now, David Haslam of the National Obesity Forum says: “It is entirely reasonable to conclude that the determinations of the 2007 Foresight Report, while shocking at the time, may now underestimate the scale of the problem.” School leaders must work with parents and health organisations to prevent this frightening prediction from becoming reality.

Further information
www.who.int/dietphysicalactivity/childhood/en/index.html